Journal of the American College of Cardiology · 2024
Measuring Absolute Coronary Flow and Microvascular Resistance by Thermodilution: JACC Review Topic of the Week.
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Belmonte Marta, Gallinoro Emanuele, Pijls Nico H J, Bertolone Dario Tino, Keulards Danielle C J, Viscusi Michele Mattia, Storozhenko Tatyana, Mizukami Takuya, Mahendiran Thabo, Seki Ruiko, Fournier Stephane, de Vos Annemiek, Adjedj Julien, Barbato Emanuele, Sonck Jeroen, Damman Peter, Keeble Thomas, Fawaz Samer, Gutiérrez-Barrios Alejandro, Paradies Valeria, Bouisset Frederic, Kern Morton J, Fearon William F, Collet Carlos, De Bruyne Bernard
Аннотация
Diagnosing coronary microvascular dysfunction remains challenging, primarily due to the lack of direct measurements of absolute coronary blood flow (Q) and microvascular resistance (Rμ). However, there has been recent progress with the development and validation of continuous intracoronary thermodilution, which offers a simplified and validated approach for clinical use. This technique enables direct quantification of Q and Rμ, leading to precise and accurate evaluation of the coronary microcirculation. To ensure consistent and reliable results, it is crucial to follow a standardized protocol when performing continuous intracoronary thermodilution measurements. This document aims to summarize the principles of thermodilution-derived absolute coronary flow measurements and propose a standardized method for conducting these assessments. The proposed standardization serves as a guide to ensure the best practice of the method, enhancing the clinical assessment of the coronary microcirculation.